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Diagnosing ulnar neuropathy at the elbow on MRI: importance of the longitudinal extent of the hyperintense ulnar nerve

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Abstract

Objective

To evaluate the usefulness of the longitudinal extent (LE) of high ulnar nerve signal intensity (SI) for the diagnosis of ulnar neuropathy at the elbow (UNE).

Materials and methods

This retrospective study included 68 patients who underwent elbow MRI. Twenty-seven and 41 patients were enrolled in the UNE and control groups, respectively. Qualitative and quantitative analyses of the SI and size of the ulnar nerve at the cubital tunnel, proximal, and distal to the cubital tunnel were performed. Cross-sectional area (CSA) and nerve-to-muscle contrast ratio (NMCR) were measured at each level. The LE of the hyperintense ulnar nerve was evaluated using axial and coronal images. The presence of space-occupying lesions (SOLs), subluxation, and muscle denervation were recorded. Univariate and multivariate analyses were performed to identify independent predictive factors.

Results

Ulnar nerve hyperintensity at and distal to the cubital tunnel, presence of compression, SOL, muscle denervation, LE of hyperintense ulnar nerve, NMCR, and CSA at and distal to the cubital tunnel significantly differed between the two groups. Multivariate logistic regression analysis showed that the LE of the hyperintense ulnar nerve and CSA at the cubital tunnel were independent predictive factors for UNE (p < 0.05).

Conclusion

LE of the hyperintense ulnar nerve could be a useful predictive factor for UNE.

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Authors and Affiliations

  1. Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-Gu, Seoul, 156-755, Republic of Korea

    Sujin Kim, Bo Mi Chung, Guen Young Lee & Joonho Hur

  2. Department of Radiology, Veterans Health Service Medical Center, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, Republic of Korea

    Wan Tae Kim & Joo Hee Kim

  3. Veterans Health Service Medical Center, Veterans Medical Research Institute, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, Republic of Korea

    Young Lee

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  1. Sujin Kim
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Correspondence to Bo Mi Chung.

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This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived.

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The authors declare no competing interests.

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Kim, S., Chung, B.M., Kim, W.T. et al. Diagnosing ulnar neuropathy at the elbow on MRI: importance of the longitudinal extent of the hyperintense ulnar nerve. Skeletal Radiol 51, 1473–1481 (2022). https://doi.org/10.1007/s00256-022-03990-1

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  • DOI: https://doi.org/10.1007/s00256-022-03990-1

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